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PRO-OBAMACARE STATES LEADING IN ENROLLMENT – Pro-Obamacare states are cramming new enrollees into private health coverage at a far faster rate than states that are letting the federal government carry the load. Pro’s Brett Norman reports: “Of the 10 states that have enrolled the biggest chunk of the potential market, nine are operating their own exchanges, according to an analysis by the Kaiser Family Foundation of the latest enrollment figures. State-based exchanges have access to tens of millions of dollars in outreach grants that can’t be spent in the states where the federal government is running the exchanges.” http://politico.pro/1j9W6NH

--One notable exception is Massachusetts, where just 2 percent of the state’s 259,000 eligible individuals had signed up — dead last in the nation. The state’s exchange has been largely dysfunctional, forcing officials there to implement workarounds that have greatly slowed their enrollment efforts. Still, it’s a jarring stat, considering Massachusetts started out with a seven-year head start running its own exchange. The report: http://bit.ly/1fDBU8J

Happy Tuesday and welcome to PULSE. We’re officially a quarter of the way through President Barack Obama’s second term and Obamacare’s still at the top of the agenda. We’re thinking we’ll get some down time in, oh, 2036 or so.

“Hello PULSE my old friend, I’ve come to talk with you again.”

STUDY: LETTING CANCELED PLANS LIVE WON’T DAMAGE EXCHANGES — The Obama administration’s 11th-hour maneuver to let people keep canceled health insurance plans won’t do much to undermine health insurance exchanges, according to research released this morning by the RAND Corporation. “The study predicts the president’s action will have only minimal effect on enrollment and premiums,” according to RAND. A Republican-sponsored plan that would also allow new customers to buy into once-canceled policies would have the most harmful effect on exchanges, leading to “sharply lower enrollment,” the study concludes.

ALTARUM: HEALTH SPENDING INCHES UP BUT PRICES REMAIN LOW — National health spending is still low but may be on the upswing, according to briefs posted Friday by the Altarum Institute’s Center for Sustainable Health Spending. Over the first 11 months of 2013, health spending grew at an annualized rate of 4 percent, according to the research, and in November, spending grew 4.5 percent faster than November 2012. Health spending in November also clocked in at 17.2 percent of GDP compared to 16 percent at the start of the recession. Separately, Altarum found that health care prices grew 1.1 percent in December, a near record-low. The spending brief: http://bit.ly/1add39T; The price brief: http://bit.ly/1mbaN2G

--Meanwhile, the health care sector shed 6,000 jobs in December, according to a third Altarum brief, the first monthly drop since July 2003 and only the second since 1989, when the institute began collecting data. Most of the decline was a result of a 4,100-job loss in ambulatory care and a 2,400-job loss in hospitals. Residential care facilities gained 500 jobs. The labor brief: http://bit.ly/1add7Gx

GOP SENATORS NEEDLE HHS ON MEDICARE — Six Republican senators chided HHS today for what they said were continuously misleading descriptions of the Affordable Care Act’s benefits to Medicare recipients. The letter calls out agency officials for describing in a December press release “no cost” preventive benefits for seniors without mentioning both the $716 billion taken from Medicare by the health law and the fact that those services still costs taxpayers money. “[I]gnoring the facts does not change them. Unless Congress intervenes, seniors will lose health services to specific Medicare cuts in the health care law,” they wrote. The letter was signed by Sens. Tom Coburn (R-Okla.), John Thune (R-S.D.), Chuck Grassley (R-Iowa), Pat Roberts (R-Kan.), Mike Enzi (R-Wyo.) and Richard Burr (R-N.C.).

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STATE WEEK — State legislatures returned to action in large swaths of the nation and immediately revisited Medicaid expansion. Check out what a handful of governors had to say about it during State of the State addresses last week, as well as other news from the state capitals. http://politico.pro/1e9rVBE

--‘STATE OF THE STATE’ SEASON CONTINUES; MORE MEDICAID CLUES? — This week, the seven governors will deliver addresses, including three in states that haven’t expanded Medicaid under the Affordable Care Act. Gov. Jay Nixon of Missouri is the likeliest to push lawmakers toward expansion — he recently reaffirmed his commitment to pursuing expansion this year and can look to the south at Republican-dominated Arkansas for inspiration. A Democratic governor there managed to work with Republican supermajorities to craft an alternative version of expansion, and he’s eyeing a similar feat. South Carolian’s Republican Gov. Nikki Haley and Wisconsin’s Republican Gov. Scott Walker, both slated to deliver speeches this week, have sworn off Medicaid expansion altogether and, if they follow the trend set by other expansion opponents, could reaffirm that commitment in their addresses.

IN JOURNAL ARTICLE, ONCOLOGISTS PUSH FOR SINGLE-PAYER — A pair of oncologists who favor a Canada-style single-payer health care system took their argument to the pages of the Journal of Oncology practice on Friday. Drs. Ray Drasga and Lawrence Einhorn, both of Indiana, argue that difficulty paying for cancer care has caused patients to delay or skip important care — and it’s getting worse despite — and perhaps because of — the Affordable Care Act, they add. The article: http://bit.ly/1m9lz9q

HAPPY BIRTHDAY – PULSE would like to offer warm birthday wishes to Pro Health’s own Jennifer Haberkorn, who celebrates today by continuing her dogged pursuit of the truth in health care. Send her your own birthday wishes: @jenhab.

HEALTH IT CHIEF: MEDICAL RECORD INCENTIVES WORKING — Four in five office-based doctors used an electronic health records system, a sign that the Obama administration’s incentives are encouraging the adoption of new recordkeeping technology, HHS’s top health IT officials wrote in a blog post Friday. “Doctors and hospitals are using these tools to reduce mistakes and hospital readmissions, provide patients with more information that enable them to stay healthy and allow for rewarding health care providers for delivering quality, not quantity, of care,” wrote Karen DeSalvo, the new National Coordinator for Health IT. Citing new CDC survey data that analyzes Medicare and Medicaid’s EHR Incentive program, DeSalvo said 13 percent of doctors described having advanced systems that would qualify for further “meaningful use” incentives when the administration begins considering them in October. The survey: http://1.usa.gov/1jbxPJx

WHAT WE’RE READING

Susan Jaffe writes in the Washington Post about efforts to trim a massive backlog of consumer-initiated appeals for Medicare coverage: http://wapo.st/1dJghm7

The New York Times looks at the surge of Medicaid coverage under the Affordable Care Act and the peace of mind it’s brought to poor Americans: http://nyti.ms/LKXNpC

The Wall Street Journal editorial board argues that Obamacare isn’t necessarily here to stay and suggests the Obama administration is catering to insurers by tweaking risk-adjustment and reinsurance programs. http://on.wsj.com/1aGtPsH

Insurance industry consultant Bob Laszewski opines on research suggesting most of the newly insured under the ACA previously had insurance. http://bit.ly/1ii7MAc

Newly minted Boston Herald health care reporter, Priyanka Dayal McCluskey, reveals that a Massachusetts-based CO-OP plan — which has received $156 million in federal funds — is struggling to enroll members thanks to the state’s faulty enrollment website: http://bit.ly/1hysg4M

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